AMA Journal of Ethics®

Illuminating the art of medicine

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. May 2013, Volume 15, Number 5: 399-487.

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May 2013 Contents

Ethics of Pain Measurement and Management

Ethics Poll

The pain rating scale currently in clinical use asks people to rate how they feel from 0 (no pain) to 10, the most intense pain imaginable. Which of the following best expresses what you think about this scale?

It’s a good way to measure pain.

It’s the best we can do for sensations that are subjective experiences.

We should develop a functionality scale, based on what a person can or cannot do because of the pain.

Don’t know.

A narcotics contract is an agreement signed by a patient with pain and the physicians who is going to prescribe narcotics for that patient. Most narcotics contracts stipulate that the patient can get prescriptions from one physician only and have them filled at one pharmacy only; lost drugs will not be replaced; and some monitoring of drug use by pill count or urine sample will take place. Do you think that narcotics contracts are fair to patients? (Select the best answer.)

Yes, if all patients who receive narcotics have to sign them.

Yes, if only patients with histories of substance abuse or drug-seeking behavior have to sign them.

No, because they are not used for other classes of dangerous drugs, only for narcotics.

No they are not fair but they are necessary for protection of the patient, they physician, and the community.

Do you think that use of marijuana for treatment of pain should be legal? (Select the best answer.)

Yes. It should be legalized for treatment of pain across the U.S.

The voters of each state should decide whether to legalize it in their state.

No. It should be illegal in all of the U.S. because there are better pain-relief alternatives.

No. It should be illegal in all states because legal use of "medical marijuana" opens the door to legal recreational use.